Posted on January 26, 2017

Between 2004 and 2014, rates of US adolescent cigarette smoking decreased, even as teen e-cigarette use increased rapidly between 2011 and 2014. As a result, some have suggested that e-cigarettes have contributed to declining cigarette smoking among youth.

However, authors of the study “E-cigarettes and National Adolescent Cigarette Use: 2004-2014,” to be published in the February 2017 issue of Pediatrics (published online Jan. 23), used the CDC’s National Youth Tobacco Survey to analyze trends in cigarette and e-cigarette use among youth between 2004 and 2014. They found that the advent of e-cigarettes had no effect on already declining cigarette smoking among youth. In fact, combined current use of e-cigarette and cigarette use (accounting for dual use) in 2014 was higher than cigarette smoking alone in 2009. In addition, the authors analyzed the psychosocial characteristics of e-cigarette users and cigarette smokers and found that e-cigarette users would be unlikely to have initiated tobacco product use with cigarettes.

This finding calls into question whether these youth would have ever initiated nicotine use at all had e-cigarettes not been available. The authors suggest that including e-cigarettes in smoke-free laws, state tobacco control programs, and national media campaigns, as well as taxing e-cigarettes and eliminating youth-friendly flavors, would combat rapidly rising e-cigarette use among adolescents without causing cigarette smoking to increate among youth.